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Lab Dx Test2 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Normal 8hr fasting adult blood sugar values (venous sample)

A

70-100 mg/dL

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2
Q

Prediabetes blood sugar fasting (impaired fasting glucose)

A

100-125 mg/dL

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3
Q

Prediabetes blood sugar 2 hours PPG value (impaired glucose tolerance)

A

140-199 mg/dL

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4
Q

4 means of diagnosing diabetes

A

2 occations of: _>_6.5% HbA1C, _>_126 fasting, SINGLE GTT _>_200, OR symptoms present with _>_200 ramdom

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5
Q

Normal hemoglobin A1c range

A

2.2-4.8%

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6
Q

Hemoglobin A1c is an index of average _____ over the prior _____ (time span)

A

Hemoglobin A1c is an index of average *blood glucose levels* over the prior *2-3 months*

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7
Q

Blood glucose “panic” values?

A

_>_400 mg/dL or < 40mg/dl

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8
Q

C-peptide chain test used to identify what?

A

Severe insulin deficiency

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9
Q

When would you use an antibody test for DM? (glutamic acid decarboxylase, tyrosine phosphate, insulin Ab’s, Islet Cell Ab’s)

A

Only if you are unsure of type 1 vs. type 2

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10
Q

Which of the following thyroid conditions cause abnormal function? Which typically do not?

A

Hypothyroidism Hyperthyroidism Thyroiditis Thyroid nodules Thyroid cancers

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11
Q

What is the initial screening test for thyroid function?

A

TSH/thyrotropin

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12
Q

What is a normal TSH value range? is fasting required?

A

0.5-5.0 mlU/L. no.

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13
Q

What drugs may increase TSH? (2)

A

*Lithium,* Potassium iodide

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14
Q

What drugs may decrease TSH? (4)

A

ASA NSAIDS Heparin Corticosteroids

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15
Q

What circulating proteins affect TOTAL TH levels (but not free T3, T4)?

A

TBG, albumin

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16
Q

Will alterations in the amount of TBG (thyroid binding globulin) be symptomatic?

A

NO

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17
Q

In what conditions/states will there be an INCREASE in TBG? (3)

A

*High estrogen states (pregnancy, OCPs) Infectious hepatitis*

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18
Q

In what conditions/states will there be a DECREASE in TBG? (6)

A

*Liver disease, Major stress,*Malnutrition,Protein losing nephropathy, Androgens, Estrogen deficiency (menopause), stress

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19
Q

To which two proteins do thyroid hormones bind?

A

TBG, Albumin

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20
Q

Used as a tumor marker for thyroid malignancy

A

Thyroglobulin

21
Q

Tested after thyroidectomy (and radioactive iodine ablations) to see if functional thyroid tissue

A

Thyroglobulin

22
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s (autoimmune)

23
Q

In hypothyroidism, labs will show __ T4, __ TSH, and positive __

A

In hypothyroidism, labs will show *decreased* T4, *increased* TSH, and positive *thyroid antibodies*

24
Q

What is the most common cause of hyperthyroidism?

A

Graves’ (autoimmune)

25
Q

In hyperthyroidism, labs will show __ T4, __ TSH, and positive __

A

In hyperthyroidism, labs will show *increased* T4, *decreased* TSH, and positive *Thyroid Stimulating Immunoglobulins*

26
Q

What are the cells that produce epinephrine and norepinephrine? Where are these cells located?

A

Chromaffin cells, Adrenal medulla

27
Q

What is a rare tumor of chromaffin cells?

A

Pheochromocytoma

28
Q

Signs/symptoms of a pheochromocytoma mock what other condition?

A

Anxiety/panic attack

29
Q

In what conditions is aldosterone elevated? (4)

A

Hyperaldosteronism (Conn’s), Congenital adrenal hyperplasia, Hypoatremia, Hyperkalemia

30
Q

In what conditions is aldosterone decreased? (4)

A

Addison’s, Renin deficiency, Hyperatremia, Antihypertensive therapy

31
Q

Cortisol opposes what other secretion?

A

Insulin (increases insulin resistance)

32
Q

Cortisol __ blood sugars

A

Raises

33
Q

What conditions/diseases cause an increase in cortisol? (4)

A

*High estrogen states (pregnancy, OCPs),*Cushing’s*, * Stress, Alcoholism, Depression, Anorexia, Obesity

34
Q

What conditions/diseases cause a decrease in cortisol? (3)

A

Adrenal insufficiency (Addison’s), Congential adrenal hyperplasia, Hypothyroidism

35
Q

What are some screenings for Cushing’s disease/syndrome? (3)

A

Overnight dexamethasone suppression test, 24 hr urine, 11pm salivary cortisol

36
Q

What conditions are required for an insulin level

A

fast for 8 hrs, pack in ice

37
Q

Is whole blood or plasma preferred for glucose levels

A

Plasma (will read 12% higher than whole blood)

38
Q

What amount of glucose is given for GTT? What conditions does the test require?

A

75g administered. Must have been fasting for 8-10 hours and able to take glucose levels 2 hours after administration. 1 hr for gestational diabetes.

39
Q

In what tubes are glucose levels and A1C levels taken?

A

Glucose= red or tiger top. HbA1C= lavender

40
Q

An elevated C-peptide or insulin level could indicate (2)

A

insulinoma or type 2 diabetes

41
Q

What test measures acetone and acetoacetate in the urine

A

nitroprusside reaction

42
Q

How will factitious insulin affect screening tests for diabetes

A

the insulin levels will be abnormally high, but c-peptide is not (normally c-pep is eqimolar)

43
Q

Interfering factor for TSH levels (2)

A

nutritional status, radioactive I

44
Q

How is the overnight dexamethazone suppression test performed

A

administer dexamethasone (glucocorticoid suppressant) at 11:30 to measure whether morning corticol levels are lowered

45
Q

3 means of testing cortisol levels

A

blood, urine, or salivary

46
Q

How is adrenal insufficiency tested via ACTH stimulation? What disease is this useful for?

A

COSYNTROPIN TEST: check if cortisol, aldosterone rise appropriately at 30, 60 mins. Addison’s.

47
Q

What is the action of aldosterone

A

sodium/water absorption and potassium excretion

48
Q

What test is used when hyperaldosteronism is suspected. In what position must the patient be placed for the blood draw?

A

aldosterone levels. Upright (aldosterone levels lower when lying down)

49
Q

what is the screening test of choice for pheo’s

A

metanephrine(including normetanephrine)

Lab Dx Test2 (6 decks)

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